Table 5 - uploaded by Helen M Lloyd
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Background:
Measuring patient experiences of healthcare is increasingly emphasized as a mechanism to measure, benchmark and drive quality improvement, clinical effectiveness and patient safety at both national and local NHS level. Person-centred coordinated care (P3C) is the conjunction of two constructs; person-centred care and care coordination....
Contexts in source publication
Context 1
... generating item scores how- ever, dichotomous items should be scored as 0,3 to ensure equal weighting between ordinal/polytomous items and dichotomous items. IIC and IDV were satisfactory for the majority of items [24], however due to an intrinsic link between care coordination and person-centred care, some items load on both care coordination and person centredness, resulting in low IDV values for those items (see Tables 5 for further [30]. ...
Context 2
... P3CEQ contains a combination of Likert-type scales (0-3) and dichotomous items (0, 3). Participants' scores for the Person-centred care scale are calculated by summing all scores in the person-centred care scale (see Table 5). Care coordination scores are calculated iden- tically to person-centred care scores, with the exception of Q8. ...
Context 3
... and face validity were assessed previously [19]. There was some overlap on three items in the scale (see Table 5). With these items, it is difficult to distinguish between person- centredness and care coordination due to the overlapping constructs. ...
Context 4
... some items were included in both the person-centred care and care coordination scales they naturally had low IDV values, however, as previously stated, for these items it is difficult to disentangle the difference between person centred care and care coordination. The items were found to be unidimensional both as part of the person centred care and care coordination scales (see Table 5) and should therefore be considered appropriate for use within each scale. ...
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Citations
... The screening of references did not identify additional eligible studies. After full-text reading, one study was excluded because it was not a PROM validation study [35], six studies were excluded because they aimed to measure patient-centredness of care rather than patient-centredness of consultations [36][37][38][39][40][41], and the remaining two studies were excluded because they targeted the wrong patient population [42][43][44]. More detail available in Appendix 1 (PRISMA flow chart) and Appendix 2 (reasons for exclusion). ...
... Content validation 1: Item extraction, construction of a draft PROM and face validity Although no PROMs were eligible for full item extraction, the identified PROMs were reviewed for relevant items or domains concerning our selected framework [14]. Six PROMs had one or more items eligible for extraction [36,38,39,[41][42][43][44]. We extracted 102 items and sorted them into the five remaining domains in the selected framework. ...
Introduction:
Validated patient-reported outcome measures (PROMs) are crucial for assessing patients' experiences in the healthcare system. Both clinically and theoretically, patient-centered consultations are essential in patient-care, and are often suggested as the optimal strategy in caring for patients with multimorbidity.
Aim:
To either identify or develop and validate a patient-reported outcome measure (PROM) to assess patient-centredness in consultations for patients with multimorbidity in general practice.
Methods:
We attempted to identify an existing PROM through a systematic literature review. If a suitable PROM was not identified, we planned to (1) construct a draft PROM based on items from existing PROMs, (2) conduct group and individual interviews among members of the target population to ensure comprehensibility, comprehensiveness and relevance, and (3) perform a psychometric validation in a broad sample of patients from primary care.
Results:
We did not identify an eligible PROM in the literature review. The item extraction and face validity meetings resulted in a new PROM consisting of 47 items divided into five domains: biopsychosocial perspective; `patient-as-person'; sharing power and responsibility; therapeutic alliance; and coordinated care. The interviews resulted in a number of changes to the layout and phrasing as well as the deletion of items. The PROM used in the psychometric validation consisted of 28 items. Psychometric validation showed high internal consistency, overall high reliability, and moderate fit indices in the confirmatory factor analysis for all five domains. Few items demonstrated differential item functioning concerning variables such as age, sex, and education.
Conclusions:
This study successfully developed and validated a PROM to measure patient-centredness in consultations for patients with multimorbidity. The five domains demonstrated high reliability and validity, making it a valuable tool for measuring patient-centredness of consultations in general practice.
Trial registration:
Trial registration number (data for psychometric validation): https://clinicaltrials.gov : NCT05676541 Registration Date: 2022-12-16.
... Existen herramientas basadas en marcos teóricos de CCP que evalúan la percepción de los usuarios sobre el proceso asistencial (Patient-Reported Experience Measures, PREMs) y sobre los resultados de salud (Patient-Reported Outcome Measures, PROMs) [20][21][22] . A pesar de que es relevante que existan herramientas que evalúen también la perspectiva de los profesionales de la salud para promover un entorno laboral saludable, son escasos los instrumentos que incluyen ambas perspectivas [22][23][24] . ...
... Existen herramientas basadas en marcos teóricos de CCP que evalúan la percepción de los usuarios sobre el proceso asistencial (Patient-Reported Experience Measures, PREMs) y sobre los resultados de salud (Patient-Reported Outcome Measures, PROMs) [20][21][22] . A pesar de que es relevante que existan herramientas que evalúen también la perspectiva de los profesionales de la salud para promover un entorno laboral saludable, son escasos los instrumentos que incluyen ambas perspectivas [22][23][24] . Por ejemplo, el Person-centred Coordinated Care Experience Questionnaire (P3CEQ), diseñado en el Reino Unido para evaluar las experiencias de atención de personas con enfermedades crónicas, cuenta con un enfoque prioritario en la coordinación asistencial y en la atención centrada en la persona 22 . ...
... A pesar de que es relevante que existan herramientas que evalúen también la perspectiva de los profesionales de la salud para promover un entorno laboral saludable, son escasos los instrumentos que incluyen ambas perspectivas [22][23][24] . Por ejemplo, el Person-centred Coordinated Care Experience Questionnaire (P3CEQ), diseñado en el Reino Unido para evaluar las experiencias de atención de personas con enfermedades crónicas, cuenta con un enfoque prioritario en la coordinación asistencial y en la atención centrada en la persona 22 . La escala Individualized Care Scale (ICS), de origen finlandés 23,25 , carece de dimensiones que consideren la relación interprofesional y el entorno en el que se brinda el cuidado 26 . ...
... Of all the patient reported measures (validated and new scales and sets of adapted and new items) in the field version of the survey, we selected a PREM measure that was developed and tested among persons with one or more chronic conditions, the Patient-Centred Coordinated Care Experience Questionnaire (P3CEQ) [16,17]. The P3CEQ consists of 10 items measuring person-centred care and care coordination, with two items being dichotomous (having a responsible health personnel or not; having a care plan or not) and the rest with multiple and varying response categories (mostly "Not at all" to "Always"). ...
Background
The International Survey of People living with Chronic Conditions (OECD-PaRIS survey), aims to systematically gather patient-reported experiences (PREMs) and - outcomes (PROMs) and potential predictors for these outcomes for persons with chronic conditions as well as information from professionals about health care provided. In such patient surveys, the advantages of a multilevel (nested) approach in which patients are sampled ‘within providers’ need to be balanced against the potential for bias if patient populations from participating GPs significantly differ from those of non-participating GPs. The objective was to assess the effects of general practitioner (GP) non-participation on the representativeness of the Norwegian patient data of the International Survey of People living with Chronic Conditions (OECD-PaRIS survey).
Methods
To test all aspects of the first main PaRIS survey, it was preceded by a field trial which this paper reports on the Norwegian part of. For the Norwegian part of the field trial in 2022, we randomly sampled and surveyed 75 GPs and 125 patients 45 years and older for each GP, regardless of whether their GP were also participating in the study. GPs were sampled from a national register that included all GPs. The surveys were primarily digital, but we sent postal questionnaires to non-digital patients and non-responding digital patients. We compared GP and patient characteristics as well as patient-reported experiences and outcomes according to GP participation status in bivariate analysis, supplemented with multiple linear regressions with PREMs/PROMs as dependent variables and participation status as independent adjusting for significant patient factors.
Results
17 of 75 sampled GPs participated (22.7%), of which 993 of 2,015 patients responded (49.3%). 3,347 of 7,080 patients of non-responding GPs answered (47.3%). Persons with chronic conditions from participating GPs reported significantly better patient-centred coordinated care (p = 0.017), overall experiences with the GP office the last 12 months (p = 0.004), mental well-being (p = 0.039) and mental health (p = 0.013) than patients from non-participating GPs. The raw differences between participating and non-participating GPs on patient-reported experiences and – outcomes varied from 1.5 to 2.9 points on a 0-100 scale, and from 2.2 to 3.0 after adjustment for case-mix.
Conclusions
The Norwegian field trial indicates that estimates based on participants in the PaRIS survey may modestly overestimate patient-reported experiences and -outcomes at the aggregated level and the need for more research within and across countries to identify and address this potential bias.
... This approach allows us to see the characteristics of each pilot at the beginning of the intervention and to observe the initial differences that will serve to perform a correct analysis of the data afterwards. The questionnaires included in the database were the following: EQ-5D-5L to measure selfreported health-related quality of life [30], Health Care Empowerment Questionnaire (HCEQ) to assess users' empowerment [31], Brief Symptom Inventory (BSI-18) to measure psychological distress [32], and the Person-Centred Coordinated Care Experience Questionnaire (P3CEQ) to evaluate several domains of person-centred coordinated care from the perspective of the user [33]. Additionally, specific-purposed questions were included . ...
Background and objective: People experiencing homelessness PEH face significant health challenges and disparities in healthcare access due to barriers such as unstable housing, limited resources, and social stigma. In response, the European Union has initiated efforts to address these disparities. The CANCERLESS project, part of this initiative, has created the first European multi-centre dataset for cancer prevention in PEH. This work aims to evaluate and describe the heterogeneity of PEH across pilot sites and to provide data quality metrics for reliable future research.
Methods: The dataset comprises 652 cases: 142 from Vienna, 158 from Athens and Thessaloniki, 197 from Madrid, and 155 from the United Kingdom. All participants fit classifications from the European Typology of Homelessness and Housing Exclusion. This longitudinal study collected questionnaires at baseline, four weeks, and at the end of the intervention. The 180-question survey covered sociodemographic data, overall health, mental health, empowerment, and interpersonal communication. Data variability was assessed using information theory and geometric methods to analyse discrepancies in distributions and completeness across the dataset.
Results: Significant variability was found among the four pilot countries, both overall and within specific sections, except for the health section. Madrid showed the largest discrepancies, with a high number of missing values related to interpersonal communication and healthcare service use.
Conclusion: Health data may be comparable across the four countries, but further analysis should account for location-specific differences. This study underscores the heterogeneity among PEH and the critical need for data quality assessments to inform future research and policymaking in this field.
... Implementing person-centred care also benefits healthcare professionals, teams, and organisations [28]. Patient-reported care experiences correlate with the quality of care delivered, including patient safety and clinical outcomes [54][55][56]. ...
Purpose
To describe how healthcare professionals, patients, and their significant others understand the concept of ‘person-centred care’ in an oncology ICU.
Methods
This study followed the associative group analysis (AGA) method, a quali-quantitative research approach.The population included healthcare professionals, their patients, and significant others in a four-bed oncology adult intensive care unit. Whole population sampling (n = 22) allowed all healthcare professionals to participate. Maximum variation purposive sampling was used to identify patients and their significant others (n = 22). Data were collected during either face-to-face or telephonic individual interviews. Free associations were weighted using a validated weighting system. Words with similar meanings were then grouped into themes. The themes were then deductively grouped according to the domains of the Person-centred Practice Framework.
Results
Participants had a limited understanding of person-centred care and could only identify six of the 23 constructs of the Person-centred Practice Framework. Healthcare professionals embraced the idea of person-centred care, but their understanding of the concept remains vague. Person-centred care remains conceptual in this oncology intensive care unit because the interpretation and operationalisation of the concept are misaligned at various health service levels.
Conclusion
Organisations should invest in work-based learning to enable staff to understand the concept of person-centred care. Healthcare workers also need to self-evaluate how they work and be able to adjust their working style to be more person-centred.
... 2,19,20 To guide the transition to a P3C model and assess its impact on outcomes and quality of care, evidence and policies recognize the importance of measuring patient experience and perspectives. 15,[21][22][23] Several patient-reported experience measures (PREMs) have been developed to assess healthcare from the patient's perspective. 2 However, many of these PREMs focus on care provided by a single discipline or on medical interventions for a specific condition, and are not well suited to assessing the complexity of care for multiple chronic conditions. ...
... 19 The Person-Centered Coordinated Care Experience Questionnaire (P3CEQ) is a PREM designed in the United Kingdom (UK) to explicitly assess P3C from the perspective of people with long-term conditions. 15,22 Its development involved commissioners, healthcare professionals, and patients with chronic conditions, the latter contributing as patient representatives and expert co-designers. 15 The P3CEQ was created to reflect the 5 core domains of the P3C: information and communication process, care planning, transitions, goals and outcomes, and decision making. ...
... 15 The P3CEQ was created to reflect the 5 core domains of the P3C: information and communication process, care planning, transitions, goals and outcomes, and decision making. 22 It is a concise, efficient and user-friendly questionnaire suitable for routine practice and capable of providing feedback during service development. 15,22 It has been assessed in both the United Kingdom and the Netherlands as a valid and reliable measure of P3C in people with long-term conditions, and has shown strong face, construct, and ecological validity, with sensitivity to change. ...
Objective
This study aimed to use the Person-Centered Coordinated Care Experience Questionnaire (P3CEQ) to assess the experience of person-centered coordinated care among people with long-term conditions in the Balearic Islands, Spain.
Methods
Over 1300 participants receiving treatment for chronic conditions or HIV pre-exposure prophylaxis were invited to complete the P3CEQ and a socio-demographic questionnaire, both administered electronically via the Naveta app. The P3CEQ assesses the key domains of the P3C through an 11-item questionnaire. Items 1, 2, 3, 4, 5, 8, 9 and 10 assess specifically person-centredness (PC subscale), while items 5, 6, 7, 8 and 9 measure care coordination (CC subscale; question 7 includes 4 sub-questions to specifically assess care plans). Descriptive statistics were used to summarize patient characteristics and P3CEQ items scores. Data analysis included chi-squared test of independence, Student’s t-test and analysis of variance test. Pairwise comparisons were adjusted by Bonferroni correction.
Results
The P3CEQ and a socio-demographic questionnaire were sent to 1313 individuals (651 men, 657 women, 5 ‘other gender’). A response rate of 35.34% was achieved, with 464 P3CEQ responders (223 men and 241 women). Significant differences in response rates were observed by age, smoking status, alcohol consumption, membership of patient organizations, and use of alternative medicine. Care planning was rated significantly lower than other measured domains. Women experienced less person-centered care than men (16.64 vs 17.91) and rated care coordination worse than their male counterparts (9.18 vs 10.23). There were also differences in scores between medical condition types, with cancer and inflammatory bowel disease patients rating highest for both person-centered care (21.20 and 19.13, respectively) and care coordination (10.70 vs 10.88, respectively). Patients with skin and rheumatic diseases rated lowest their experience of person-centered care. People with higher education and those employed or studying experienced better person-centeredness.
Conclusion
Using the P3CEQ, we detected significant differences in the care experiences of people with chronic conditions, suggesting the need to address potential gender biases, social inequalities, and the poorer ratings observed for certain conditions in the study population.
... With the advancement of Patient Reported Outcome Measures (PROMS) [43,44], Patient Reported Experience Measures (PREMS) [45] and the World Health Organization (WHO) [15] emphasis on the development of people-centred and integrated health systems, greater emphasis has been placed on developing measures to determine the person-centredness of care experienced by service users. Several instruments have been developed to measure the effectiveness of person-centred care in specific services, such as mental health [45], primary care [46,47], aged care [48,49] and community care [50]. However only one other instrument adopts a generic approach to evaluating services users' experiences of person-centred care [51]. ...
Background
Person-centred healthcare focuses on placing the beliefs and values of service users at the centre of decision-making and creating the context for practitioners to do this effectively. Measuring the outcomes arising from person-centred practices is complex and challenging and often adopts multiple perspectives and approaches. Few measurement frameworks are grounded in an explicit person-centred theoretical framework.
Aims
In the study reported in this paper, the aim was to develop a valid and reliable instrument to measure the experience of person-centred care by service users (patients)–The Person-centred Practice Inventory-Care (PCPI-C).
Methods
Based on the ‘person-centred processes’ construct of an established Person-centred Practice Framework (PCPF), a service user instrument was developed to complement existing instruments informed by the same theoretical framework–the PCPF. An exploratory sequential mixed methods design was used to construct and test the instrument, working with international partners and service users in Scotland, Northern Ireland, Australia and Austria. A three-phase approach was adopted to the development and testing of the PCPI-C: Phase 1 –Item Selection: following an iterative process a list of 20 items were agreed upon by the research team for use in phase 2 of the project; Phase 2 –Instrument Development and Refinement: Development of the PCPI-C was undertaken through two stages. Stage 1 involved three sequential rounds of data collection using focus groups in Scotland, Australia and Northern Ireland; Stage 2 involved distributing the instrument to members of a global community of practice for person-centred practice for review and feedback, as well as refinement and translation through one: one interviews in Austria. Phase 3: Testing Structural Validity of the PCPI-C: A sample of 452 participants participated in this phase of the study. Service users participating in existing cancer research in the UK, Malta, Poland and Portugal, as well as care homes research in Austria completed the draft PCPI-C. Data were collected over a 14month period (January 2021-March 2022). Descriptive and measures of dispersion statistics were generated for all items to help inform subsequent analysis. Confirmatory factor analysis was conducted using maximum likelihood robust extraction testing of the 5-factor model of the PCPI-C.
Results
The testing of the PCPI-C resulted in a final 18 item instrument. The results demonstrate that the PCPI-C is a psychometrically sound instrument, supporting a five-factor model that examines the service user’s perspective of what constitutes person-centred care.
Conclusion and implications
This new instrument is generic in nature and so can be used to evaluate how person-centredness is perceived by service users in different healthcare contexts and at different levels of an organisation. Thus, it brings a service user perspective to an organisation-wide evaluation framework.
... High-quality healthcare comprises safety, effectiveness, timeliness, efficiency, equity, and patient-centeredness (Anhang Price et al., 2014;Institute of Medicine, 2001). According to others (Lloyd et al., 2019;Lloyd et al., 2018;Sugavanam et al., 2018), person-centered coordinated care comprises five core domains: information and communication, care planning, transitions, patient-defined goals or outcomes, and shared decision-making. Considering the complex healthcare needs of patients with cancer, patientcenteredness is warranted and acknowledged as an essential element of high-quality cancer care (Beattie et al., 2013;Langberg et al., 2019). ...
... Person-Centered Coordinated Care Experience Questionnaire (P3CEQ). To assess patients' experience the authors used a translated Norwegian version of the P3CEQ (Lloyd et al., 2019). There is no current gold standard for PREMs (Beattie et al., 2015), and although there are other generic measures available (Danielsen et al., 2007), the P3CEQ has recently been validated for patients receiving radiotherapy (Robinson, 2018;Sollid et al., 2022). ...
... There is no current gold standard for PREMs (Beattie et al., 2015), and although there are other generic measures available (Danielsen et al., 2007), the P3CEQ has recently been validated for patients receiving radiotherapy (Robinson, 2018;Sollid et al., 2022). The instrument seems to capture the variation in patients' experiences (Lloyd et al., 2019;Sollid et al., 2022) and thereby allows for differentiation between experiences reported from a complex care trajectory. Furthermore, the instrument focuses on personcentered care, transitions, decision-making, information, and communication (Lloyd et al., 2019;Sugavanam et al., 2018), which are all highly relevant areas for patients with cancer, and the subscales can help identify potential areas for improvement in service delivery, including in a radiotherapy setting. ...
Introduction
Radiotherapy is the main treatment modality in cancer. There is sparse knowledge on how patients with cancer experience their radiotherapy trajectory, and which factors might be associated with patients’ experiences.
Objectives
The aim of the present study was to explore how adults with cancer receiving radiotherapy evaluate the quality of their care, utilizing a patient-reported experience measure, and how patient- and service-related characteristics are associated with their evaluation.
Methods
An explorative cross-sectional study using a self-completed questionnaire to assess patients’ radiotherapy experiences was performed. Participants were recruited consecutively, within their last week of treatment, from two different hospitals in Norway from January 2021 to January 2022. Four hundred and eighty paper questionnaires were distributed to recruited patients, 240 at each hospital. Questionnaires were self-completed at home and returned by mail. The instrument person-centered coordinated care experience questionnaire (P3CEQ) was used. In addition to this, participants completed the European Organization of Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) and The Sense of Coherence 13 scale (SOC-13). Data were analyzed using descriptive statistics, parametric tests, and unadjusted/adjusted linear regression models were estimated.
Results
The study included 373 patients. Patients evaluated quality of care in terms of P3CEQ scores, with a mean score of 19.5 (standard deviation = 5.4). Lowest scores were identified in areas concerning person-centeredness and service coordination. There were no significant differences in P3CEQ scores between the younger and older groups. Having a partner and better SOC-13 scores were independently associated with the overall patient-reported experience score, whereas age was not.
Conclusion
Patient-reported experience scores indicate that improvements are needed in some areas, such as informing and involving patients in the planning and coordination of their care. Findings suggest paying special attention to patients without a partner to offer patients the best possible care.
... The questionnaires used are the validated Spanish versions and meet licensing requirements. The platform mainly included PROMS for a variety of chronic conditions (67), and only a few PREMs were administered, including the Person-Centered Coordinated Care Experience Questionnaire (P3CEQ), which is designed to assess person-centered coordinated care from the perspective of people with long-term conditions [36,37]. Other PREMs included the Self-Injection Assessment Questionnaire (SIAQ) [38,39] and a Likert scale survey to assess satisfaction with the dual follow-up (on-site and telematic care; administered annually). ...
Background
Patient-reported outcome and experience measures can play a critical role in providing patient-centered and value-based health care to a growing population of patients who are chronically ill. Value-based telemedicine platforms such as the Naveta initiative may facilitate the effective integration of these tools into health care systems.
Objective
This study aims to evaluate the response rate to electronic patient-reported outcome measures (ePROMs) and electronic patient-reported experience measures (ePREMs) among patients participating in the Naveta telemedicine initiative and its correlations with sociodemographic and clinical characteristics, as well as the evolution of the response rates over time.
Methods
Between January 1, 2021, and June 30, 2023, a total of 53,364 ePREMs and ePROMs for 20 chronic conditions were administered through the Naveta-Phemium platform. Descriptive statistics were used to summarize continuous and categorical variables. Differences in response rates within each sociodemographic variable were analyzed using logistic regression models, with significance assessed via chi-square and post hoc Tukey tests. Two-way ANOVA was used to examine the interaction between time interval and disease type on response rate evolution.
Results
A total of 3372 patients with severe chronic diseases from 64 public hospitals in Spain participated in the Naveta health questionnaire project. The overall response rate to ePROMs and ePREMs during the first 2.5 years of the Naveta initiative was 46.12% (24,704/53,364), with a baseline rate of 53.33% (7198/13,496). Several sociodemographic factors correlated with lower response rates, including male gender, older age, lower education level, frequent alcohol use, being a student, and not being physically active. There were also significant variations in response rates among different types of chronic conditions (P<.001), with the highest rates being for respiratory (433/606, 71.5%), oncologic (200/319, 62.7%), digestive (2247/3601, 62.4%), and rheumatic diseases (7506/12,982, 57.82%) and the lowest being for HIV infection (7473/22,695, 32.93%). During the first 6 months of follow-up, the response rates decreased in all disease types, except in the case of the group of patients with oncologic disease, among whom the response rate increased up to 100% (6/6). Subsequently, the overall response rate approached baseline levels.
Conclusions
Recognizing the influence of sociodemographic factors on response rates is critical to identifying barriers to participation in telemonitoring programs and ensuring inclusiveness in patient-centered health care practices. The observed decline in response rates at follow-up may be due to survey fatigue, highlighting the need for strategies to mitigate this effect. In addition, the variation in response rates across chronic conditions emphasizes the importance of tailoring telemonitoring approaches to specific patient populations.
... The PCCoc also showed an acceptable ceiling effect, which was less than for the PCCoc/rheum, suggesting that revisions have improved the possibility to capture higher levels of PCC. Capturing higher levels of perceived PCC has proven difficult in other generic instruments aimed at measuring person-centred care [21,43]. However, limiting floor-and ceiling effects are fundamental for providing measurement of sufficient precision that is sensitive to differences and responsive to changes over time [44]. ...
Aim:
To further develop the Person-Centred Care instrument for outpatient care (PCCoc), evaluate its user-friendliness and content validity, and to explore its basic psychometric properties in various outpatient settings for adults with long-term conditions.
Background:
Person-centred care (PCC) has been identified as a key factor to provide high-quality care. However, there is still a lack of instruments that are based on a clearly defined framework for PCC for persons with long-term conditions in an outpatient context. The PCCoc is a patient-reported experience measure under development aiming to fill this gap.
Methods:
First, the 35-item PCCoc was reviewed and further developed in collaboration with a user-council. Second, the revised 36-item PCCoc was tested among persons receiving outpatient care for various long-term conditions. A total of 179 persons with long-term conditions from four different specialties participated in the study. User-friendliness and content validity were assessed through structured interviews and relevance ratings of each item. Content validity index (CVI) for individual items (I-CVI) and for the overall scale (S-CVI) were calculated, and basic psychometric properties of the PCCoc using classical test theory were explored.
Results:
It took a median of 8 min for participants to complete the PCCoc. The majority found items easy to understand, response categories distinct and that no important areas were missing. Results from the CVI analyses suggested that participants found the content of the PCCoc relevant (I-CVI range 0.82-1, S-CVI = 0.95). All psychometric properties examined were satisfactory (e.g., item-total correlations, 0.45-0.75; Cronbach's alpha, 0.96; test-retest stability, 0.83).
Conclusion:
The PCCoc was considered user-friendly and relevant by the intended users, and its psychometric properties were satisfactory. This implies that the PCCoc can be a valuable instrument for evaluating and developing PCC in outpatient care for persons with long-term conditions. However, further studies of the PCCoc are needed to establish its measurement properties in various outpatient settings.
